Psychosocial Predictors of Non-adherence to Prescribed Mobility Assistive Devices by Community-dwelling Older Adults: Development of a Predictive Model
Notice bibliographique
Résumé
Mobility is essential to healthy aging and is closely related to health and overall quality of life. Mobility impairment is an early predictor of disability, and is intimately linked to falling injuries, loss of independence, hospitalization, and mortality. Mobility Assistive Devices (MADs), such as canes, walkers, and wheelchairs, provide support to older adults to improve their balance, coordination, and strength. Despite the acknowledged benefits of MADs for the older adult population research shows that as many as 75% of older adults are non-adherent to prescribed MADs. As non-adherence is a contributing factor to declines in mobility and overall quality of life, it is important to consider the reasoning behind it. Therefore, this doctoral project took a psychosocial perspective and investigated the psychosocial factors that predict non-adherence to MADs among older adults. This study considered a sample of older adult MADs users from long-term care units at the Perley Health Centre in Ottawa with different types of mobility limitations. The study examined the role of psychosocial variables using the Psychosocial Impact of Assistive Devices Scale (PIADS), social support using the Medical Outcomes Study Social Support Survey (MOS-SS), and the demographic variable of sex in the prediction of MADs non-adherence. Predictor variables that were associated with non-adherence in a univariate regression analysis were subsequently entered into a multiple regression analysis. Of the 96 residents invited to participate in the study, 49 gave their consent to participate, and out of this number, 48 completed the study, for a response rate of 51%. The data from the 48 residents (26 females and 22 males), with a mean age of 86.8 (Standard Deviation (SD) = 10.2, age range= 66 - 101), were therefore available for analysis. The most common reported mobility limitations were due to balance problems and leg weakness (29.17% for each). The most common device used was a walker (47.92%), followed by a manual wheelchair (33.33%). No statistical difference was detected between the groups of sexes regarding any of the study variables (P≥0.05). In the univariate regression analysis, the three PIADS subscales, namely, Competence, Adaptability, and Self-esteem, were significantly correlated with non-adherence (p < 0.001). Sex was an insignificant variable, while social support was significantly correlated with Competence, Adaptability, Self-esteem, and non-adherence. In the multiple regression analyses, only Self-esteem showed significant associations (p < 0.05), and the Self-esteem multivariate model explained 43.5 - 54.3% of the variance in non-adherence. This study revealed that the Self-esteem construct, which includes several concepts related to psychological wellbeing, was the only significant predictor of non-adherence among the studied sample of older adults. The theoretical and clinical implications of the findings are subsequently discussed.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,005 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».